The URL can be used to link to this page

Home My WebLink AboutBUSINESS PLAN,~_ ~.- PACIFIC PULMONARY SVC-SILLECT f~ Manager ~A~T~I ~dw ~6~s Location: 3101 SILLECT AVE 106 City BAKERSFIELD CommCode: KCFD STA 66 EPA Numb: SiteID: 015-021-002183 BusPhone: (661) 861-6160 Map 102 CommHaz Low Grid: 23D FacUnits: 1 AOV: SIC Code:3841 DunnBrad:809580996 Emergency Contact / Title Emergency Contact / Title / MANAGER KAYVEE LARSEN / SAFETY OFFICER Business Phone: (661) 861-6160x Business Phone: (415) 893-1518x239 24-Hour Phone ( - x 24-Hour Phone (800) 572-7522x Pager Phone ( ) ~a i -~~(Ux Pager Phone ( ) - x Hazmat Hazards: Fire ImmHlth DelHlth Contact KAYVEE LARSEN Phone: (415) 893-1518x239 MailAddr: 88 ROWLAND WY 300 State: CA City NAVATO Zip 94945 Owner BRADEN PARTNERS LP Phone: (415) 893-1518x247 Address 88 ROWLAND WY 300 State: CA City NOVATO Zip 94945 Period to TotalASTs: = Gal Preparers TotalUSTs: = Gal Certif'd: RSs: No ParcelNo: Emergency Directives: PROG A - HAZMAT ~N'1°~ ~'~g 21 2 007 l3asad on my inquiry of those individ~.aals responsible for oi,taining the information, I certify under penalty of la~v that I have personally examined and am familiar with the information submitt ,d and el'eve the information is true, . cura , and lete. ~ ~~ S ~ ature Dat -1- 02/05/2007 ~. i. F PACIFIC PULMONARY SVC-SILLECT SiteID: 015-021-002183 ~ ~ Hazmat Inventory _ By Facility Unit ~ ~ MCP+DailyMax Order Fixed Containers at Site ~ Hazmat Common Name... SpecHaz EPA Hazards Frm DailyMax Unit MCP OXYGEN F IH DH G 5000.00 FT3 Low -2- 02/05/2007 -3- 02/05/2007 F PACIFIC PULMONARY SVC-SILLECT SiteID: 015-021-002183 ~ ~ Inventory Item 0001 Facility Unit: Fixed Containers at Site ~ COMMON NAME / CHEMICAL NAME OXYGEN Days On Site 365 Location within this Facility Unit Map: Grid: OUTSIDE SW CRNR CAS# 7782-44-7 STATE T TYPE PRESSURE ~ TEMPERATURE ~ CONTAINER TYPE ~GaS I Pure Above Ambient I AmY~i rent I PORT PRF.~G CYT.TTTT)F.R I AMOUNTS AT THIS LOCATION Largest Container Daily Maximum Daily Average 25.00 FT3 5000.00 FT3 2500.00 FT3 •-~ HAZARDOUS COMPONENTS oWt. RS CAS# 100.00 Oxygen, Compressed No 7782447 t11iGEitCL 1i. 7.7~.7.71~1~1V 1.7 TSecret RS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP No No No No/ Curies F IH DH / / / Low -4- 02/05/2007 F PACIFIC PULMONARY SVC-SILLECT SiteID: 015-021-002183 ~ Fast Format ~ ~ Notif./Evacuation/Medical Overall Site ~ ~ Agency Notification 04/23/2001 ~ CYLINDERS INVENTORIED DAILY, CYLINDERS HAVE INSPECTION EACH TIME THEY ARE FILLED, CYLINDERS REEQUALIFIED (HYDROSTATED) EVERY 5 YEARS FOR ALUMINUM AND EVERY 10 YEARS FOR STEEL, ALL OXYGEN LOT NUMBERS TRACKED AND RECORDED. Employee Notif./Evacuation 08/30/2005 VERBALLY TO ALL STAFF ON SITE AND BY TELEPHONE TO ALL OFF-SITE STAFF. Public Notif./Evacuation NOT NECESSARY, 02 DISSIPATES IN AIR AND IS NOT HARMFUL. 03/28/2006 Emergency Medical Plan 07/24/2006 GOOD SAMARITAN URGENT CARE CENTER, 901 OLIVE DR. -5- 02/05/2007 F PACIFIC PULMONARY SVC-SILLECT SitelD: 015-021-002183 ~ Fast Format ~ ~ Mitigation/Prevent/Abatemt Overall Site ~ Release Prevention 04/23/2001 ALL CYLINDERS ARE STORED AT AMBIENT TEMPERATURE, ALL CYLINDERS ARE IN VERTICAL OR HORIZONTAL RACKS EXCEPT LARGE CYLINDERS WHICH ARE CHAINED TO BLDG FOR SAFETY. ttC1Cd.5'C l..Vill.d111lllClll. ~.icall vt/ V 1.1161 itGAVUt I:C 1'il,~l.1 VCLL1Vll -6- 02/05/2007 -. F PACIFIC PULMONARY SVC-SILLECT SiteID: 015-021-002183 ~ Fast Format ~ ~ Site Emergency Factors Overall Site ~ oYo~:lc~l nct~u.r.ua Utility Shut-Offs 07/24/2006 A) GAS - N/A B) ELECTRICAL - MID-OFFICE SW CRNR C) WATER - S OF W PROP LINE W SIDE OF ST D) SPECIAL - NONE E) LOCK BOX - NO Fire Protec./Avail. Water PRIVATE FIRE PROTECTION - FIRE EXTINGUISHERS 01/04/2007 NEAREST FIRE HYDRANT - E OF OFFICE ACROSS ST & BACK W SIDE OF BLDG. rsuiluiny vcc:u~diic:y Level < < D ~ ~SC~ ~ ~ vG ~ ~~ G~J ~ / -7- 02/05/2007 F PACIFIC PULMONARY SVC-SILLECT SiteID: 015-021-002183 Fast Format ~ Training Overall Site ~ Employee Training 01/04/2007 MSDS SHEET ON FILE. BRIEF SUMMARY OF TRAINING PROGRAM: ALL CENTER-LEVEL POSITIONS PARTICIPATE IN POSITION-SPECIFIC ON-THE-JOB TRAINING IN A CENTER. PART OF THE INITIAL ORIENTATION TO THE CENTER OPERATIONS IS A DETAILED INTRODUCTION TO CENTER SAFETY AND OXYGEN SAFETY. THE RESPIRATORY EQUIPMENT TECHNICIAN (RET) TRAINING IS REQUIRED FOR ALL DRIVERS AND CENTER MANAGERS. IT IS A 4-DAY TRAINING THAT INCLUDES TRAINING ON ALL DELIVERY PROCEDURES, THE SAFE HANDLING AND PROCESSING OF ALL EQUIPMENT AND SAFE OXYGEN OPERATING PROCEDURES. THE PATIENT CARE COORDINATORS OCASSIONALLY DO COME IN CONTACT WITH OUR EQUIPMENT AND PARTICIPATE IN THE SERVICING OF OUR PATIENTS. THE PATIENT CARE COORDINATOR (PCC) POSITION REQUIRES A MINIMUM OF ONE WEEK TRAINING WITH A RESPIRATORY EQUIPMENT TECHNICIAN TO LEARN THE SAFE OPERATIONS OF ALL EQUIPMENT AND OXYGEN SAFETY. THE CENTER STAFF ALSO PARTICIPATES IN MONTHLY SAFETY MEETINGS AT THEIR INDIVIDUAL CENTERS: THE TOPICS INCLUDE, BUT ARE NOT LIMITED TO: EPP, CENTER SAFETY, OSHA SAFE WORK PROCEDURES, PERSONAL HYGIENE, ETC. ON AN AS NEEDED BASIS PPSC WILL COMMUNICATE OUT SPECIFIC TOPICS TO BE COVERED AS WE SEE APPROPRIATE. IN ADDITION THE CENTERS COMPLETE A CENTER SAFETY WALK-THROUGH ON A REGULAR BASIS, PROACTIVELY IDENTIFYING OPPORTUNITIES FOR IMPROVEMENT IN THEIR CENTERS TO ENSURE SAFE OPERATIONS AND EMPLOYEE SAFETY. rayc a -8- 02/05/2007 n'_ ;~ F PACIFIC PULMONARY SVC-SILLECT SiteID: 015-021-002183 ~ Fast Format ~ ~ Training Overall Site ~ nclu tui ru~uic u~c raci.u iut r u~u.~c u5c -9- 02/05/2007 ~-;;.- + PACIFIC PULMONARY _______ ___________________________ SiteID: 015-021-002183 + `~"~'- N i~ Ab2ci~Cr~,bl~ to l~ e ~6~.-e I ~ I lei Manager ~~ '~' ,-„-,rT•,~.rR. BusPhone : (-41~~9.3 '-r~~- Location: 3101 SILLECT AVE 106 Map 102 CommHaz Low City BAKERSFIELD Grid: 23D FacUnits: 1 AOV: CommCode: KCFD STA 66 SIC Code:3841 EPA Numb: DunnBrad:809580996 ~ Emergency Contact / Title ~ Emergency Contact / Title Business Phone: - Business Phone: - 24-Hour Phone r?=!-*'_~? =9~" "~~- 24-Hour Phone Pager Phone- ( ) - x Pager Phone ( ) - x Hazmat Hazards: Fire ImmHlth DelHlth Contact KAYVEE LARSEN Phone: (415) 893-1518x239 MailAddr: 88 ROWLAND WY 300 State: CA City NAVATO Zip 94945 Owner BRADEN PARTNERS LP Phone: (415) 893-1518x247 Address 88 ROWLAND WY 300 State: CA City NOVATO Zip 94945 Period to TotalASTs: = Gal Preparers. TotalUSTs: = Gal Certif' d: RSs : No ParcelNo: Emergency Directives : ~rne~q~y C~,~~ /bG~ .~~ ~ D PROG A - HAZMAT t~ pr~V (~ Ab2,c-c.~1„'.e ~ ,MG~G Qr C~~ ~11~1~~ CC...~a ~~+~~ ~~1~-~~ ~ ~ ~'-~ci~Ve-2 LG~2~er~ ~ `~a~i~ ~~~er ENj~~ 4~5~~~ - ~5~ ~a~~ J~~ 2 4 20 `~~~`-a -1~a ~6 based on my inquiry of those individuals Q~,., responsible for obtaining the information, 1 certify 11 fl 41n o under penalty of law that 1 have personally ( 111 ~./ examined and am familiar with the information ~V'` submitted and bolieve the information is true, accurate, and complete. Signature Dat -1- 03/28/2006 UNIFIED PROGRAM INSPECTION CHECKLIST, SECTION 1: Business Plan and Inventory Program BAKERSFIELD FIRE DEPT Prevention Services ~It~ 900 Truxtun Ave., Suite 210 ~Rrrr ~ Bakersfield, CA 93301 Tel.: (661) 326-3979 Fax: (661) 872-2171 FACILITY NAM NSPECTION DATE INSPECTION TIME ~~ ~ ~ ~- --o - fr ~ 3c~ ADDRESS ~ HONE NO. O OF EMPLOYEES FACILITY CONTACT USINESS ID NUMBER 15-021- Section 1: Business Plan and Inventory Program UTINE ^ COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION C V ~ C=Compliance OPERATION V=Violation COMMENTS ^ APPROPRIATE PERMIT ON HAND ~- ^ BUSIn13SS PLAN CONTACT INFORMATION ACCURATE ^ VISIBLE ADDRESS ~^ CORRECT OCCUPANCY ~^ VERIFICATION OF INVENTORY MATERIALS ~^ VERIFICATION OF QUANTITIES VERIFICATION OF LOCATION ~^ PROPER SEGREGATION OF MATERIAL ~^ VERIFICATION OF MSDS AVAILABILITY ^ VERIFICATION OF HAZ MAT TRAINING ^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES /~ ^ EMERGENCY PROCEDURES ADEQUATE ^ CONTAINERS PROPERLY LABELED ^ HOUSEKEEPING ~^ FIRE PROTECTION ^ SITE DIAGRAM ADEQUATE 8 ON HAND ANY HAZARDOUS WASTE ON SITE? EXPLAIN ^ YES pf~DlO QUESTIONS REGARDING^THIS INSPECTION? PLEASE CALL US AT (661) 328-3978 mti~/~ 7!t'~ L/'t~ Inspector (Please Print) Ire revention 1" in /Shift of Site/Station # White -Prevention Services Yellow -Station Copy Pink -Business Copy FD2049 (Rev.lYL05)